How to Navigate Challenging Issues in Couples Therapy - Psychology Today

Imagine for a moment, that you are going, on your own, to see a couples therapist about problems and issues in your intimate relationship, when they hit you with a barrage of troublesome questions: Is your partner willing to come in now, and if not now, then when? Would you rather just work in single therapy on your own issues? If the two of you agree to come in, can you afford a therapist for you, one for your partner, and one for the both of you?

I do not know about your experiences with therapy but the one time my wife and went for couples counseling we were more overwhelmed about all of these possible issues confronting us than the ones we brought with us to work on in the first place. We almost bolted the session even though we both practice couples therapy in our professional lives. As couple-clients, though, we were uncertain, confused, and unnecessarily stressed. Smartly, we requested that our therapist take a session or two and explain the benefits and risks of these questions. Ironically, my partner and I were in unison together on this.

This post will clarify and make some recommendations about the above questions, and provide suggestions on what to look for when selecting a couples therapist.

Big issue number one

Perhaps the biggest issue to confront is: Do you want couples therapy or individual therapy? If a marriage is "on the rocks," couples therapy may be the best place to start, and your therapist can direct you later about other options (Gurman & Synder, 2011).

However, what happens if your partner refuses to join you? While single therapy is always a respectful option, my first suggestion would be to have your therapist explain the complications, risks, and benefits of each format, even if this takes up a whole session.

For example, if you choose individual therapy to work on your own issues, the marriage may be in worse shape three months down the line. Alternatively, your individual work may positively impact the marriage as well. Your decisions carry risks.

Before you decide on the therapy format, ask your therapist to share with you a constructive message you can carry back to your partner about your perception of your relationship's health.

For example, your therapist may encourage a dialogue like this: "I would love for you to join me in couples therapy. I believe it will help our relationship." "I am afraid that if I participate in therapy alone, it might eventually draw us apart, and that scares me because I value our close relationship." "Please let me know soon."

While a vulnerable and constructive message may or may not work at a given moment, it does clear the air for more communication later on. You might also feel better about yourself while you continue to work on your own issues in single therapy.

Big issue number two

The second issue is more about the ideal or optimal way to work on your relationship. For example, your therapist may suggest single therapy for you, your partner, and couples therapy for the both of you. While this sounds inviting, the practical limitations need to be discussed with each other. Do you and your partner have the time, money, and other resources to participate in these multiple formats? The financial costs alone, even with insurance, may be more than you can manage.

Then there is the issue of communication among the three therapists, who may operate their therapy programs differently. This can be confusing, to say the least. For example, I have seen clients get one set of advice from one therapist and something quite different from their couples therapist. What do couple-clients do in those situations?

THE BASICS

Therapeutic differences are confusing and rarely resolved, even when you the two of you waive consent and expect agreement and compromise among your treating therapists. Remember, you may now have as many as three different therapists working for you.

Choosing the "right" therapist

I recommend three criteria for selecting a couples therapist, assuming you already have a list of qualified and licensed therapists to begin with:

1. Ask them: How many years of experience do you have working with couples? And have you had special education or training in treating couples? I do not see a general physician for my diabetes; I go to a specialist who has vast experience with the disease and is current in the field. Couples counseling is also a specialty. Not all therapists enjoy or have training using this format. Your close relationship is too important to not give this question serious thought.

Therapy Essential Reads

2. Inquire about your prospective therapist's attitude in doing couples work. Therapists who have done this type of work for decades may be burned out and dread working with couple-clients at present. Couples therapy is a bit more difficult than single therapy. The treating therapist has you, your partner, and the relationship itself to navigate. This can be stressful because there is a lot going on at the same time. You have every right as a consumer to ask and get reasonable answers back on these or related questions.

3. Lastly, are you and your partner able to bond and have a positive alliance or relationship with your treating therapist? While therapy/client fit or connection is a necessary ingredient in all therapies, couples therapy involves working with two different couple-clients at the same time, making it more complex and harder to manage (Wampold, et.al., 2011).

It is even more critical that you and your partner have a warm and caring relationship with your couples therapist. The more people in a session, the greater the chance for miscommunication and negative emotions.

My recommendation is an open and honest discussion about any and all issues that might interfere with accepting treatment with your couples therapist. It is the best way to repair ruptures in your relationships that at least on a small scale, are inevitable.

Besides, this level of communication is in itself therapeutic. Is that not one of the reasons why the two of you are there?

Some concluding thoughts

Once you select a couples therapist based on the criteria of experience, attitude, and positive connections with you and your partner, you may have elevated the odds that therapy may work more favorably for you and your partner.

By the way, hundreds of research studies support the effectiveness of couples therapy over and above waiting list/placebo control clients and prospective clients choosing not to enter therapy (Lambert, 2011). Overall, this is very good news for people seeking couples therapy.

To find a therapist, visit the Psychology Today Therapy Directory.

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